dysgerminoma

未分化胚細胞腫

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/21 17:11:27」(JST)

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Dysgerminoma
Micrograph a seminoma, a tumour that is histologically indistinguishable from a dysgerminoma. H&E stain.
Classification and external resources
ICD-9-CM	183.0
ICD-O	9060/3
MeSH	D004407

A dysgerminoma is a type of germ cell tumor; it usually is malignant and usually occurs in the ovary.

A tumor of the identical histology but not occurring in the ovary may be described by an alternate name: seminoma in the testis or germinoma in the central nervous system or other parts of the body.

Dysgerminoma accounts for less than 1% of ovarian tumors overall. Dysgerminoma usually occurs in adolescence and early adult life; about 5% occur in pre-pubertal children. Dysgerminoma is extremely rare after age 50. Dysgerminoma occurs in both ovaries in 10% of patients and, in a further 10%, there is microscopic tumor in the other ovary.

Abnormal gonads (due to gonadal dysgenesis and androgen insensitivity syndrome) have a high risk of developing a dysgerminoma. Most dysgerminomas are associated with elevated serum lactic dehydrogenase (LDH), which is sometimes used as a tumor marker.

Presentation

They are exceptionally associated with hypercalcemia. On gross examination, dysgerminomas present with a smooth, bosselated (knobby) external surface, and is soft, fleshy and either cream-coloured, gray, pink or tan when cut. Microscopic examination typically reveals uniform cells that resemble primordial germ cells. Typically, the stroma contains lymphocytes and about 20% of patients have sarcoid-like granulomas.

Metastases are most often present in the lymph nodes.

Treatment

Dysgerminomas, like other seminomatous germ cell tumors, are very sensitive to both chemotherapy and radiotherapy. For this reason, with treatment patients' chances of long-term survival, even cure, is excellent.

References

UpToDate Contents

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• 1. 卵巣胚細胞腫瘍：病理、臨床症状、および診断 ovarian germ cell neoplasms pathology clinical manifestations and diagnosis
• 2. 卵巣の悪性胚細胞腫瘍の治療 treatment of malignant germ cell tumors of the ovary
• 3. カウデン症候群などのPTEN過誤腫症候群 pten hamartoma tumor syndrome including cowden syndrome
• 4. 付属器腫瘤の鑑別診断 differential diagnosis of the adnexal mass
• 5. 妊娠中における卵巣癌の臨床症状および診断 clinical manifestations and diagnosis of ovarian cancer in pregnancy

English Journal

• Ovarian dysgerminoma associated with fibrosarcoma: a case report.

• Alvarado-Cabrero I, Valencia-Cedillo R, Mohs-Alfaro M, De Anda-Gonzalez J.SourceDepartment of Pathology (I.A-C.), Mexican Oncology Hospital Pathologist Mexican Oncology Hospital (R.V-C., J.DeA-G.), Mexico Pathologist University of Costa Rica (M.M-A.), Costa Rica.
• International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists.Int J Gynecol Pathol.2011 Sep;30(5):466-9.
• A 35-year-old woman presented with abdominal pain and weight loss. Pelvic computed tomography showed a 15 cm mass in the left ovary. Grossly, the removed ovary was completely replaced by a solid tumor mass. On histological analysis (100 sections), the lesion showed the typical morphological features
• PMID 21804387

• Expression and histopathological correlation of CCR9 and CCL25 in ovarian cancer.

• Singh R, Stockard CR, Grizzle WE, Lillard JW Jr, Singh S.SourceDepartment of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA.
• International journal of oncology.Int J Oncol.2011 Aug;39(2):373-81. doi: 10.3892/ijo.2011.1059. Epub 2011 May 31.
• Ovarian carcinoma is the most lethal gynecological malignancy among women and its poor prognosis is mainly due to metastasis. Chemokine receptor CCR9 is primarily expressed by a small subset of immune cells. The interactions between CCL25 and CCR9 have been implicated in leukocyte trafficking to the
• PMID 21637913

Japanese Journal

• JEB(carboplatin,etoposide,bleomycin)療法を施行した卵巣悪性胚細胞腫瘍の4例

• 横須賀 とも子,田野島 玲大,加藤 宏美,柳町 昌克,梶原 良介,薬袋 周,田中 文子,藤井 久紀,後藤 裕明,宮城 悦子,山中 正二,横田 俊平
• 小児がん : 小児悪性腫瘍研究会記録 47(1), 111-115, 2010-02-25
• 4例の小児卵巣悪性胚細胞腫瘍に対し,carboplatin,etoposide,bleomycinによるJEB療法を施行した.初発時の年齢は9歳から14歳,腫瘍の病理組織診断はyolk sac tumorが2例,dysgermiminomaがl例,mixed germ cell tumorが1例であった.初発時から45?61か月現在,全例が無病生存中である.卵巣悪性胚細胞腫瘍に対して行われてきたB …
• NAID 110007575326

• 腹腔鏡下に性腺を摘出した性染色体異常 (モザイク) の2例

• 福原 健,万代 昌紀,三木 通保,藤原 浩,小西 郁生
• 日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology 25(1), 272-276, 2009-09-01
• … A laparoscopic bilateral gonadectomy was performed to avoid the risk of gonadoblastoma or dysgerminoma. …
• NAID 10026403517

Related Links

• Dysgerminoma - Wikipedia, the free encyclopedia

Dysgerminoma is the most common type of malignant germ cell ovarian cancer, although it accounts for less than 1% of ovarian tumors overall. Dysgerminoma usually occurs in adolescence and early adult life; about 5% occur in pre- pubertal ...

Related Pictures

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★リンクテーブル★

リンク元	「セミノーマ」「未分化胚細胞腫」「ディスジャーミノーマ」

「セミノーマ」

　　[★]

英

seminoma, seminomas

同

精上皮腫 disgerminoma dysgerminoma

関

精巣腫瘍

概念

• 精母細胞から生じる腫瘍。
• 似た組織像を示す卵巣腫瘍に未分化胚細胞腫 dysgerminomaがある。

疫学

• 精巣腫瘍の約50%を占める
• 40歳以上

診断

• 免疫組織化学

• human placental lactogen(HPL)：陽性
• α-fetoprotein(AFP)：陰性
• human chorionic gonadotropin(hCG)：陰性

syncytial cellはhCGが陽性かも

治療

• 高位精巣摘除術　→　化学療法・放射線療法

予後

• 化学療法によく反応し放射線感受性が高い。
• 良好
• IGCCC Prognosis

参考

• 1. 精巣腫瘍診療ガイドライン - 香川県立中央病院 (2010年)

http://www.chp-kagawa.jp/docs/seisou.pdf

「未分化胚細胞腫」

　　[★]

英

dysgerminoma

同

ジスジャーミノーマ、卵巣精上皮腫 ovarian seminoma

関

セミノーマ

後発部位

• 卵巣
• 睾丸
• 縦隔
• まれに延髄

• 悪性腫瘍で最も高頻度なのは未分化胚細胞腫

• 精巣のセミノーマ seminomaに相当する
• 両側性(5-10%, 10-20%(APT.323))　←　悪性肺細胞腫瘍の中で唯一両側発生傾向があるらしい
• 放射線感受性あり

疫学

• 若い女性に多い。妊娠に合併しうる
• 20-30歳代80%。10歳未満5% (also see APT.323

病理

• This neoplasm is composed of sheets and cords of large polyhedral cells with large nuclei and pale pink to watery cytoplasm. (APT.323)
• hCGを産生する栄養膜合胞体細胞(syncytiotrophoblastic cell)が存在することがある。

転移

• リンパ行性が多い

「ディスジャーミノーマ」

　　[★]

英

dysgerminoma

• 胚細胞が増殖した悪性腫瘍が卵巣に発生したもの。女性の胚細胞に発生した場合には当該疾患名が与えられるが、男性の精巣に発生した場合にはセミノーマ(seminoma)と呼ばれる。いずれも思春期に好発する。